An Update on the Epidemiology of Tusi ("Pink Cocaine").
Current addiction reports January 1, 2025 Nina Abukahok, Nicole D Fitzgerald, Joseph J Palamar
Tusi, or 'pink cocaine,' is a drug mixture containing ketamine and MDMA, often with additional substances like synthetic cathinones, cocaine, or methamphetamine. Its inconsistent chemical makeup complicates surveillance and harm reduction. Drug checking services have identified ketamine and MDMA as main components, with ketamine concentrations increasing over time in Spain. Surveys in Spain and Colombia show rising initiation, polysubstance use, and misclassification of tusi's contents. Harms stem largely from the polysubstance mixtures rather than any single component, yet mortality data typically focus on individual drugs. Tusi represents a novel trend: a blend of substances defined by its color and nightlife association, requiring standardized surveys, expanded drug checking, and improved toxicological monitoring.